Here are eleven steps that can help defeat chronic bacterial infections, including the infections that cause Alzheimer’s. (Note: I will justify each of these eleven steps, and cite to the scientific literature, in follow-up posts.)

1. Normalization of Vitamin D Levels.

Vitamin D is needed for the transcription of anti-microbial peptides, such as the cathelicidin LL-37 and beta-defensin, which are essential for defense against intracellular bacteria and viruses. Vitamin D deficiency is a risk factor for every chronic infection, and chronic infections tend to increase in frequency with latitude and progress most rapidly during the winter when vitamin D levels are low. In general, a serum 25-hydroxyvitamin D3 level of 40 ng/ml (100 nmol/L in SI units) is a good target. (Some people, such as Dr. John Cannell of the Vitamin D Council, believe there may be benefits to higher levels, but this is speculative.)

2. Restriction of Carb Intake to 400 Calories Per Day.

Eating a carb-rich diet is doubly bad: it increases blood glucose levels and triggers insulin release, both of which promote bacterial infections.

Insulin represses immune defenses against parasitic bacteria, by blocking production of antimicrobial peptides.

To keep both blood glucose and insulin levels low, carbohydrate consumption should be restricted to about 400 calories per day – the amount in 0.3 pounds of cooked white rice, or 1.3 pounds of sweet potatoes.

3. Restriction of Protein.

Eating minimal protein helps in two ways: it deprives bacteria of amino acids necessary for growth, like tryptophan; and it promotes autophagy, the primary means by which cells kill intracellular pathogens.

Indeed, the body’s primary defense mechanism against C. pneumoniae is tryptophan deprivation. This is why people with chronic brain infections have symptoms of serotonin deprivation, including depression, anxiety, insomnia, fatigue, impaired ability to concentrate, and low self-confidence. It’s important not to relieve this by tryptophan or 5-HTP supplementation, both of which promote bacterial growth. If symptoms are intolerable, selective serotonin reuptake inhibitor (SSRI) antidepressants, like Prozac, Paxil, or Zoloft, might be able to provide symptomatic relief. (NB: We neither recommend nor disparage these drugs.)

4. Intermittent Fasting

Autophagy is the garbage collection and recycling process of human cells. When resources are scarce, cells turn on recycling programs and send garbage collectors known as lysosomes to engulf and digest junk proteins and damaged organelles, enabling re-use of their amino and fatty acids.

Autophagy is a key part of the immune defense against parasitic bacteria. Lysosomes not only digest human junk, they seek out bacteria and digest them.

Autophagy is strongly turned after about 16 hours of fasting. The longer one fasts, the more parasitic bacteria are destroyed in lysosomes. Fasting is an easy way to improve the relative balance of power between your body and intracellular pathogens. Fasting strongly promotes autophagy in neurons, and is of therapeutic value for Alzheimer’s.

A simple strategy of intermittent fasting is to confine meals to an 8-hour window each day, thus engaging in a daily 16 hour fast. On this strategy, one might eat only between noon and 8 pm.

5. Ketogenic Fasting.

Two dangers of fasting are that it can lead to loss of muscle tissue as protein is consumed to generate ketones and glucose, and that neurons may be put under stress by glucose deprivation.

Both dangers can be ameliorated by eating ketogenic fats during the fast. “Ketogenic” means generative of ketone bodies. Ketone bodies, which are generated from fats or some proteins during fasting, are the only neuronal energy source that bacteria can’t steal. There is a large literature showing that high circulating ketone levels are neuroprotective, and ketogenic diets have been successfully tested as Alzheimer’s therapies.

The most ketogenic fats are the short- and medium-chain fats found abundantly in coconut oil. Taking plentiful fat calories from coconut oil, but no carb or protein calories and few other fats, can enable fasts to be extended substantially longer with minimal loss of muscle tissue or neuronal stress.

On a ketogenic fast, eliminate carbs and protein for a 36-hour period, from dinner one day to breakfast on the second day. During the intervening day, eat no protein or carbs, but do eat as much coconut oil as you like.

There is no limit on how much coconut oil may be consumed – but 12 tablespoons per day would produce a surfeit of ketones. NB: Always drink plenty of water during a fast. We also drink coffee with plentiful heavy cream.

6. Elimination of Wheat and Other Grains.

Wheat is a toxic food that interferes with immune defenses and impairs vitamin D function. It also generates antibodies to the thyroid, which damage the thyroid status and further impair immune function.

7. Elimination of Omega-6-Rich Oils and Inclusion of Omega-3-Rich Fish.

A high omega-6 and low omega-3 diet weakens immune defenses against intracellular pathogens and re-directs the immune system toward extracellular threats.

Note that the combination of carbohydrate, protein, and omega-6 fat restriction necessarily means that half or more of calories should be obtained from saturated and monounsaturated fats. It is important not to have a saturated fat phobia if you want to escape or defeat Alzheimer’s!

8. Fructose Minimization.

Fructose is a toxin and is deprecated on the Perfect Health Diet. One of its worst features is that promotes infections. In mice, blood levels of endotoxin, a bacterial waste product, are higher on a fructose-rich diet than on any other diet.

Therefore, sugary foods like soft drinks should be eliminated. Fruit and berries are OK in moderation. We recommend no more than 2 portions of fruit and berries per day. Most carb calories should be obtained from starchy foods, like sweet potatoes or taro or white rice.

9. Melatonin supplementation.

Whereas vitamin D is the “daylight hormone,” melatonin is the “hormone of darkness.” It is generated during sleep, and is favored by darkness. Even a little bit of light at night, like the LEDs of an alarm clock or streetlights shining through a window, can disrupt melatonin production.

Melatonin is extremely important, not least because it has powerful antibiotic effects.

To maximize melatonin production, everyone should sleep in a totally darkened room, with windows covered by opaque drapes and all lights extinguished and LCD or LED clocks turned face down.

Unfortunately, people with chronic bacterial infections will generally still be melatonin-deficient, for the same reason they are serotonin-deficient: melatonin is derived from tryptophan and serotonin. Fortunately, melatonin is easily supplemented.

A melatonin tablet can be allowed to dissolve in the mouth just before bed. High doses will generally produce a deep sleep followed by early waking; this can be remedied by using time-release capsules, or by reducing the dose.

10. Selenium and Iodine Supplementation and Thyroid Normalization.

This is basic for good health in all contexts, but optimizing thyroid hormone levels and maintaining iodine and selenium status are especially important for anyone with an infection.

Both selenium and iodine are required for proper immune function. To get iodine, white blood cells will strip iodine from thyroid hormone; for this reason, people with chronic infections are often somewhat hypothyroid, as indicated by TSH levels above 1.5.

There are too many tricks and pitfalls to thyroid normalization to describe the whole issue here, but a good start is to eliminate wheat from the diet, and to obtain 200 mcg selenium and at least 400 mcg iodine per day. Do not get too much selenium as it is toxic. Selenium and iodine may be obtained from foods: two to three Brazil nuts a day for selenium, and seaweed for iodine.

11. Vitamin C and Glutathione or NAC Supplementation.

These are important for immune function. Vitamin C supplementation is an important safety precaution because infections greatly increase the rate of loss of vitamin C, and can generate tissue scurvy with devastating consequences.

Glutathione is destroyed by stomach acid. We recommend buying reduced glutathione and taking it with a full glass of water on an empty stomach, at least 2 hours after and 1 hour before taking food. Alternatively, N-acetylcysteine (NAC) and glycine-rich foods like gelatin may be taken to promote glutathione synthesis.

Conclusion

This is by no means an exhaustive list of dietary and nutritional steps that can help against chronic infections. However, we believe these are the most powerful and important steps.

Alzheimer’s and other diseases caused by chronic bacterial infections – possibly including multiple sclerosis, Lyme disease, chronic fatigue syndromes, fibromyalgia, rheumatoid arthritis, and many others – are preventable, treatable, and often curable. These dietary steps, along with appropriate antibiotic therapy, are keys to a cure.

160 Comments.

Can NAC , vt.C and glycine taken as supplements powder be recommended to enhance Glutathion production ? And how much, if you agree with this form of supp. ? (I know whey is a good GSH precurusor, but cannot take it because of dairy allergy) I’ve been recommended to add extra glutathion supp.
Thanks for all,

In connection with the IF subject and some previous discussion of randomness a la Art Devany, I’m starting to wonder if the IF itself should be more intermittent; i.e., I’ve been doing the 8 hour, sometimes shorter, eating window daily for approaching 2 years. One of the apparently well known side-effects is that your blood sugar runs a little high in a Fasted test, presumably because your liver has gotten good at keeping you out of hypoglycemia. I wonder if some more randomness in the use of this protocol would be better, less hormetically, repetitively stressful; perhaps using MCTs during the fasting window or just not doing this every day. How is your philosophy developing on this subject?

I followed a Paleo low carb diet for the past three years with a slow weight loss of thirty pounds. I began having episodes of facial flushing, tachycardia, weakness, dizziness and nausea nine months ago after lowering my total carbs to less than 20 grams per day. After extensive medical testing, I have been diagnosed with Mast Cell Activation Syndrome which requires adherance to a strict low histamine/tyramine and possibly salicylate diet. Foods which trigger an anaphylactic type response must be eliminated. I am able to tolerate tapioca pearles, white rice and rice noodles so I have tried to stay as close as possible to the PHD guidelines. I have been gluten free for the past year also. There are numerous posters online who have developed symptoms associated with histamine intolerance after eating many of the foods included on a Paleo diet. Pork, bacon, sausage, aged meats, fish (especially canned), avocado, fermented foods, coconut products and nuts are high in biogenic amines and may cause symptoms in some individuals. I am glad that I can still eat some of the PHD safe starches to vary the limited diet which I can tolerate. Hoping that research can better predict chronic conditions through genetic mutations, environmental triggers and dietary influence.

The goal is intermittent fasting, ie eating nothing for 16 hours and then eating normally in the remaining 8. Glucose will reduce autophagy somewhat if eaten during the fast. But you need it. Too much autophagy or too much fasting are no good. But you should be able to confine both glucose and protein to an 8 hour window most days.

How much fasting is too much? I have been on PHD with recommended supplements and a daily 16/8 for 4 months, losing about one or two pounds each month. Scale says my muscle percentage is holding steady, but I have a history of overdoing things, so if daily 16/8 is not good, then I’d like to hear the dangers, if there are any.

I haven’t yet tried the recommended monthly 36-hour fast, and don’t know if I should make it ketogenic (eat mostly coconut oil) or just stick with the simple soups and veggies. I had pneumonia about two years ago, and have been coughing up goo every morning since. I’ve had one cold since then (no colds since PHD), but I’m afraid the little bugs could be lurking in my lungs, or hunkering down elsewhere, and figure any preventative actions I can take to head off infections should only benefit me. I have allergies to most antibiotics, and the Cipro-related antibiotic I took for the pneumonia had pretty horrible side effects—it made my joints all rubbery and I had to stay out of the sun because I got welts within five minutes. The side effects went away within a month of taking it. So while I have health insurance, I generally avoid my doctor outside the yearly testing window, and each time I go, I feel like she’s trying to get me on drugs, so unless I know exactly what to ask for or have some kind of serious problem, I stick to the basics of the blood tests and try to do everything I can to stay healthy. I read on the website and in your book that these infections can be non-symptomatic, so I’m just sort of balancing between paranoia, science, and hypochondria. Any brief comments could help. Thanks.

I believe my mom has alzheimers although she has not yet been diagnosed. She is certainly having serious memory failure, so some sort of dementia. I read this post and it just seems like way to much for a person without a science or medical background to understand and implement on their own. She is already on a gluten free but not grain free diet. What would be the most important steps to do for starters. Could we work our way through it in stages?

Hi Paul. Thanks for your response. I found one of the vitamin D you recommended on your supplenments page is a small easy to swallow softgel so that is good. But the reviews on your recommended magnesium all say large and hard to swallow, which is a problem. Can you recommend a smaller tablet? I think a liquid would be hard for her to remember to take, but her pill regimen is well established and she remembers most days. Thanks.

The cheapest form of magnesium is magnesium citrate powder, you can get that in 8 oz jars and if she sprinkles a small amount (say 1/4 of the enclosed scoop) per day on to her food then she’ll be all set. It tastes sweet. If she doesn’t like using the scoop she can dip a banana in to coat the end and eat that.

Hi Paul,
Have your book and been reading your blog since the start of the year and eating as closely as possible.

I have been trying to find out the cause of my years of fatigue and slow brain with the help of PHD. 🙂 And now I just found out I have spine degeneration since my 30s 🙁

Elimination of gluten was quite helpful but improvement stalled. I have sleep interuptions which I manage with melatonin/5HTP. A high protein dinner does help, but I need a minimum 200gm slab of meat. Seem like a lot for a 55kg asian female.

I started IF for 3 weeks with coconut oil, but do not feel any difference in energy levels. I do not tolerate carbs well in the morning and get into a slump with just a slice of GF bread (25g carb) within 30min of ingestion even with butter, veg and protein.
But fasting BG always alright, last check 90mg/dl.
TSH 1.6, Cu 98ug/dL, Zn 12umol/L
Ferritin 32ug/L, vitD 60nmol/L.
Full blood exam, Renal and Liver Fx all within Lab ranges.

So I am now on the chronic infection hypothesis, however, I also noted on the blog that it is correlated to low blood cholesterol, which I never had. My numbers have always been on the high normal range. TC 230mg/dl, LDL 125mg/dl.

Besides asking for a “Metamatrix” stool test from my doctor, would any kind of blood Ig or antibody test be useful to detect viral and bacterial infection?

Hi Kerri
I’ve got very similar symptoms-sleeping problems, fatigue, no difference in energy levels with Intermittent Fasting, I think we are the same gender; race is also Asian, and lab results very similar to you (TSH of 1.6, TC 200, LDL 135 mg/dL)

I really appreciate (and am beginning to implement) these suggestions for overcoming chronic infections. I’ve had health issues for 3 years which I’ve been told by various doctors are due to a post-viral syndrome, probable subclinical MS, neuro-Lyme disease, and several other possibilities, which I’ve come a long way toward conquering, but still have a ways to go. I’ve noted for many years that nearly all my symptoms are mediated to a significant degree by diet.

I’ve been taking 5-HTP for 18 months with only positive results. It, along with magnesium and ALC, has been a lifesaver. I’ve made several unsuccessful attempts to wean off it. I’m not comfortable with the idea of trying SSRIs. I’ll plan to implement as many of the above suggestions as I can, and then make another attempt to wean off the 5-HTP.

I experience panic/anxiety symptoms and heightened visual light sensitivity anytime I eat more than very small amounts of any type of fat. I have never found an explanation for this. But it certainly presents an interesting challenge when trying to decrease protein and carb consumption.

I’d like to restrict protein so as not to provide amino acids to feed the bacteria. How much protein should be eaten? I get uncontrollable carb cravings without adequate animal protein at meals.

Dear Paul, my 5 year old son was diagnosed with Lyme this past week after I found a rash of pink rings on his legs. I never found a bullseye or tick. However blood tests revealed that he has Lyme . I started him on the antibiotic and the dr is claiming that once he has completed the 21 day course of meds, he will be cured of Lyme . He never exhibited any symptoms beyond the rash…. My question for you is are the tips listed above appropiate for youg children? And if you could offer anymore advice would be so very greatly appreciated because I’m very overwhelmed and confused. Thanks for your time
Daisy

I think antibiotics are appropriate. Early treatment can often forestall serious chronic disease. There is no guarantee that he will be cured in 21 days, but chances are much better. A good diet, and regular sun exposure, will help a lot.

This study seems to support your theory of bacterial infections playing a role in Alzheimer’s.

Since my grandmother and mother both succumbed to the disease by their mid-70s I am at a tenfold greater risk. At 57 I believe I am starting to see the very beginning of signs so I am very interested in anything I can do to delay or prevent such an outcome. If antibiotic therapy could help I would certainly find a neurologist to work with.

First I just want to thank you for providing the best information about health and diet there is. I’m a medical student and I’m seriously wondering if not you should implement your ideas on every medical school there is – I wish it was so.

Anyways, I recently figured out that I have pre-diabetes (6,9mm/L blood glucose after 12 hour fasting, 3 times tested). I’m 24 years old, not skinny nor fat, and work out fairly regularly. I was quite surprised I came out the those results. I guess the answer is in my genes since I have several diabetic relatives, atleast after a large part of my family went from being farmers in a small village in Syria to being city dwellers in a big town in Sweden. I’ve started a ketogenic diet and I already follow all of your other diet/supplement recommendations. I feel wonderful! It feels as if I’ve come out of a depressed state, less anxiety, more energy and I already feel kind of feel normal. I’ve always had problems with being social for longer times, studying (brain fog fast) and morning energy levels. That seems to be a memory past, at least for now since I’m only a week in. Do you think I should worry about infection/brain infections since got so fantastic results with glucose starvation, or is it just the results of less glucotoxicity?

I also have vasomotor rhinits that seems to become less and less troublesome, and my chronically I’ll shoulders and feet joint pains are starting to fade away. I’ve always been overly stressed and have had sleep problems since I was a kid, so my guess is that the chronic hyperglycemia has disrupted my parasympathetic nervous system, causing an decrease in the cholinergic anti-inflammatory pathway (joint problems) and also the nervousness/sleeplessness/anxiety problems. After reading your article I’ve started to think it could be an infection instead, since most of my problems started to get much worse 4 years ago when I had a throat infection (virus according to doctor) that went over after a week. That same year I had 3 cases of sinusitis which I’ve bascially never had before. It all baffels me! What are your thoughts?

Prediabetes is usually due to an infection of the pancreas/small intestine/liver area, many infections can do it, even influenza virus: http://www.ncbi.nlm.nih.gov/pubmed/23097451. So I would expect the prediabetes was caused by whatever infection gave you the sore throat, you were swallowing the germs and some of them took root in the pancreas most likely. Possibly the same infection is responsible for the other symptoms, including the rhinitis and joint pain.

Whatever it was, it sounds like the ketogenic diet is effective against it (presumably bacterial then, maybe viral) and you should be able to recover fully.

I have had chronic fatigue syndrome for at least five years, if not longer. Following the Weston A Price principles has allowed me to be less symptomatic than my peers with the same illness, so much so that my medical doctor doesn’t believe I have anything but depression (which I don’t!).

If my CFS is caused by a chronic infection, is it possible to cure it by only the above eleven guidelines? Or can something this systemic only be cured by your 11 recommendations AND medication? (antibiotics, antivirals, etc.)

My 14 year old son had a tick stuck to his leg today. I called the doctor and they told me to bring the tick in tomorrow to be tested. They said they do not treat unless the bulls eye rash develops or if after 3 weeks the bloodwork is positive. Is there anything I can give him to try and prevent him from developing lyme if the tick was infected? I’m not even sure that it’s definitely a tick but it’s tiny and does look like a tick.

Hi Paul
Great article! I was not familiar with brain conditions associated with C. pneumoniae. I do have a question about one section: “Indeed, the body’s primary defense mechanism against C. pneumoniae is tryptophan deprivation…. It’s important not to relieve this by tryptophan or 5-HTP supplementation, both of which promote bacterial growth.” I recommend both amino acids to my clients and have not heard or seen anything about supplementation per se promoting bacterial growth. Do you by any chance have research link/s you can share? Thanks!

The situation with tryptophan is exactly similar. The innate immune response to bacteria sequesters tryptophan which, like iron, is often a rate-limiting factor for microbial metabolism (for protein synthesis and niacin synthesis). Taking extra tryptophan defeats this immune defense and will promote infections.

I understand the urge to use tryptophan for symptom management (the immune sequestration of tryptophan can lead to depression, http://www.ncbi.nlm.nih.gov/pubmed/26554725), but logically, it is going to exacerbate many infections.

You have in the past talked about bacterial infections and Alzheimers. Now in the news they speak about the cold sore virus and Alzheimers. Would you make the same recommendations if someone has this virus?

I am APOE4/4. I am 48 years old and don’t have Alzheimer’s at this point, but I understand my risk is quite high (based on genetics alone). Would you recommend that people with ultra high risk genetics also follow these guidelines?

I have been keeping my carbs to about 400 calories, for weight loss purposes, but my intention was to raise them up to 500-600 if I hit my goal weight, and possibly more on heavy workout days. Now I’m questioning this strategy.

There is so much conflicting advice about the ideal diet for APOE4 carriers. All of my previous doctors have told me to avoid saturated fat like the plague due to APOE4’s not being able to clear cholesterol from the blood. My LDL-P is a bit on the high side, despite a mostly Paleo diet, so it’s hard to totally disregard. I don’t think the APOE4 gene was intended for a long life, so I may just be screwed either way. I guess I could try living on olives?

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